Can your provide a response to this discussion? 150 word minimum w/ academic references.
Question 1: According to the case study information, how would you classify the severity of D.R.’s asthma attack?
The categorization of the intensity of asthmatic episodes, utilizing clinical characteristics and easily measurable factors like peak flow rates, is widely regarded as a valuable approach to the management of bronchial asthma (Cloutier, et al., 2020). According to the Global Initiative for Asthma, (GINA) Global Strategy for Asthma Management and Prevention, 2019, and the National Asthma Education and Prevention Program (NAEPP) guidelines, our patient D.R. is experiencing an asthma exacerbation that can be classified as moderate persistent asthma. As per Merck & Co.’s MDS manual asthma classification table, 2023, the specific criteria used to guide the determination of D.R.’s severity are as follows: Symptoms and Risks all ages, Nighttime Awakenings Adults and children ≥ 5 years: > 1 time/week but not nightly, SABA rescue inhaler use for symptoms daily, Interference with normal activitysome limitation, Forced Expiratory Volume (FEV1) Adults and children ≥ 5 years: 60–80%, Risk of asthma exacerbations requiring oral corticosteroid bursts more frequent and intense events indicate greater severity (Merck & Co, 2023).
Question 2: Name the most common triggers for asthma in any given patient and specify in your answer which ones you consider applied to D.R. in the case study.
The most common triggers for asthma, according to the National Heart, Lung, and Blood Institute (NHLBI) 2020, the most common asthma triggers in any given patient are substances that induce or exacerbate asthma symptoms. A few of these triggers are outdoor allergens caused by pollens and mold; indoor allergens caused by dust mites, pet dander, and mold; respiratory infections such as rhinitis, influenza (flu), or COVID-19 as well as bacterial respiratory infections; irritants such as inhalation of tobacco smoke, commonly referred to as secondhand smoke, poor quality atmospheric air and potent odors like the ones in perfumes, or chemicals from paint, and cleaning products are all potential triggers. Physical activity can also illicit exercise-induced bronchoconstriction (EIB), a condition that affects certain individuals although with treatment most people should be able to remain active; emotions and stress, including rage, sobbing, and laughter; weather such as inhalation of cold air or poor air quality may also trigger asthma; certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), beta-blockers, and aspirin have the potential to induce asthma symptoms in individuals who are susceptible to the condition. Gastroesophageal Reflux Disease (GERD) has the capacity to worsen asthma symptoms in individuals due to the occurrence of acid reflux as does allergic reactions particularly those elicited by food allergies or insect stings in individuals with heightened susceptibility (NIH/National Heart, Blood, & Lung, 2023).
Several triggers could apply to D.R.’s current condition as asthma is complex and there are a multitude of factors that could be considered. Acute disease worsening in the form of asthma attacks or exacerbations can occur at any time without warning and can be fatal (Lommatzsch, Buhl, & Korn, 2020). Due to the acute onset of D.R.’s symptoms such as stuffy nose, watery eyes, and postnasal drainage, an allergic reaction fits this criterion best. This could be due to outdoor or indoor allergens or a viral respiratory infection. He may also be experiencing symptoms from exercise-induced asthma. He may also be experiencing a reaction to an environmental irritant that could have been induced by smoke, a strong odor at his workplace, etc. Another possibility is that he may not have been very compliant with his treatment, and this led to poor control and ineffective treatment. He may also be experiencing something stressful in his personal life that could aggravate his symptoms due to his emotional nature.
Based on your knowledge and your research, please explain the factors that might be the etiology of D.R. being an asthmatic patient.
D.R.’s symptoms began four days ago; he has observed a persistent decline in his peak flow rates since it began. D.R. has also noted a decreased response to his albuterol inhaler therapy. To better understand his condition, it is imperative to consider the following factors as part of his etiology.
Asthma frequently has a genetic component, and people who have a family history of asthma or other allergic conditions are more likely to develop the disease (Thomsen, 2015). In D.R.’s case, researching his family history could reveal crucial information about whether genetic factors contribute to his asthmatic condition. D.R. has symptoms of an allergic reaction, such as a stuffy nose, watery eyes, and postnasal drainage. Allergens such as pollen, dust mites, pet dander, or mold can cause these symptoms, especially in people who are allergic to them. An allergist could help D.R. figure out what the allergen inducing his symptoms is by conducting a simple test that tests for specificity. D.R. mentions that his usual albuterol inhaler is no longer providing adequate relief, indicating a reduced sensitivity to short-acting bronchodilators (Kuruvilla, Lee, & Lee, 2019).
